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WorksheetsEndocrine patho
Total questions: 12
Worksheet time: 11hrs 11mins
Ten days after thyroid surgery, a patient returns to his physician complaining of problems that have gradually developed in the intervening period. It is determined that he has parathyroid deficiency due to inadvertent damage to the parathyroid glands. From the list below, select the signs and symptoms from which the patient is likely to present with. Explain your answer in full.
A. Low plasma phosphate and Ca2+ levels and tetany.
B. Low plasma phosphate and Ca2+ levels and tetanus.
C. Low plasma Ca2+ level, increased muscular excitability, and spasm of the muscles of the upper extremity.
A 50-year-old man presents with headache and weakness for several weeks. On investigation, he is blood pressure is 160/95 mmHg and hypokalaemic. Serum aldosterone is elevated, so imaging is performed. The result shows an adenoma in the adrenal zona glomerulosa, so primary hyperaldosteronism is suspected. Additional tests are ordered.
Briefly explain the elevated blood pressure and headache in the patient.
Explain the expected changes (increase, decrease or no change) to serum renin and serum angiotensin II in this patient in the context of this case.
Mrs A was treated with a prednisone (a corticosteroid) for her eye infection. She later presents with increased blood glucose levels. Briefly explain why she later presented with the elevated blood glucose levels.
A 32-year-old woman was referred to the local hospital by her family doctor. She had an enlarged thyroid on examination. Upon questioning she indicated that her mother and sister took thyroid medication, and did not know for what reasons. Blood samples were taken for the measurement of TSH and T4. The results of the plasma hormones were:
TSH: 10.1U/L (normal: 0.4 - 4.2)
Free T4: 0.6 ng/dl (normal: 0.8 - 2.7)
Briefly explain the hormone results and the enlarged thyroid gland.
The following sets of plasma values listed in the table below were obtained from three individuals, A, B, and C. Explaining your answer, which set of data is consistent with a patient with Conn’s syndrome.
A 56-year-old man with oat cell carcinoma of the lung is admitted to the hospital after having a grand mal seizure. The man’s lung tumour is diagnosed as inoperable. He is treated with an intravenous infusion of hypertonic NaCl and is stabilized and discharged. He is given demeclocycline, an ADH antagonist, and is ordered to severely limit his water intake. Laboratory studies yield the following information:
Serum
[Na+], 110 mEq/L (normal, 145 mEq/L)
Osmolarity, 225 mOsm/L (normal, 290 mOsm/L)
Urine
Osmolarity, 650 mOsm/L
Briefly explain the man’s serum and urine values.
Ten days after thyroid surgery, a patient returns to his physician complaining of problems that have gradually developed in the intervening period. It is determined that he has parathyroid deficiency due to inadvertent damage to the parathyroid glands. Briefly explain why this patient is likely to present with low plasma Ca2+ level, increased muscular excitability, and spasm of the muscles of the upper extremity.
A 39-year-old woman complains of lethargy and progressive weight gain despite a decreased appetite. On examination you notice her dry coarse skin, cold peripheries, a pulse of 52 bpm and a goitre. Investigations showed her
TSH was 10.0 mU/ml (normal range 0.40–4.0 mU/ml)
and her free T4 was 3.5 pmol/L (normal range 9.0–25.0 pmol/L).
Explain the above hormonal investigation results and state the diagnosis
What is the most common cause worldwide for this condition?
Explain why the thyroid gland is enlarged.
Explain why T4 is given as thyroxine replacement and not T3
A 14-year-old child with type 1 diabetes is admitted at the causality department at a local hospital following a collapse whilst playing soccer. Blood tests show the following:
Blood glucose 14.5 mmol/L
Na+ 135 mmol/L
The Na+ in this patient is indicative of dehydration.
Explain the dehydration in this patient.
A 38-year-old female presents to you complaining of weight gain, fatigue, low mood and muscle weakness. Blood results showed a 9.00 am
ACTH 100 ng/L (normal range 0–47 ng/L)
Serum cortisol 750 nmol/L (normal range 119–618 nmol/L).
What disorder does this clinical case describe?
Explain why the patient is likely to present with Increased blood pressure
Explain why the patient is likely to present with Increased fasting blood glucose level.
Explain why the patient is likely to present with Muscle weakness.
Explain why the patient is likely to present with their face getting rounder
Anna, a 62-year-old woman, arrives at her doctor's office with a series of symptoms
that have developed over the past few weeks. She complains of persistent thirst,
frequent trips to the bathroom, fatigue that seems unrelenting, and a recent onset of
blurred vision. Anna's medical history reveals she has struggled with obesity for many
years and has been managing hypertension with medication. Additionally, there's a
family history of diabetes mellitus, with both her parents diagnosed with the condition
in their later years.
During her examination, Anna's BMI is calculated to be 35, and her blood pressure reads
152/88 mmHg. A fasting blood glucose test reveals a level of 190 mg/dL, and her HbA1c
comes back at 8.7%
Considering Anna's symptoms, medical history, and the diagnostic results, what is
the underlying cause of her symptoms. Explain your answer
Explain in detail, what could be the cause of blurred vision in Anna's case.
Explain the pathophysiological mechanism associated with the persistent thirst,
frequent urination, and unrelenting fatigue observed in Anna's situation.
Differentiate between insulin resistance, and Type II Diabetes Mellitus?
